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-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Day-Care Danger

Bryce J. Christensen and Nicole M. King

Advocates of maternal employment desperately want everyone to believe that young children in day care are perfectly safe. But researchers continue to uncover the evidence that such children are actually at risk. The latest piece of evidence comes in a study recently conducted at Boston University, where researchers established that children in day-care centers run a particularly high risk of contracting a troublesome respiratory pathogen.

The pathogen at the center of the new study is Nontypeable Haemophilus influenzae (NTHi), a germ doctors regard as “an important cause of respiratory tract illness.” “In children,” the researchers explain, “disease due to NTHi is observed as a frequent complication of viral respiratory tract infections, manifesting as either acute otitis media [infection of the inner ear] or sinusitis.” And though the medical evidence on this point is less clear than it is with otitis media and sinusitis, the researchers also consider the involvement of this microbe in lower-respiratory infections in children to be “likely.” Even more unsettling is a new study, cited by the Boston scholars, identifying “NTHi [as] one of the major pathogens found in children with recurrent community-acquired pneumonia.”

To determine the young children who were most likely to carry NTHi, the researchers conducted a cross-sectional pilot study involving 273 infants living in a community of 100,000 near Boston. The medical tests on these infants indicated that approximately one in six (16.1%) had been colonized with NTHi. But not all of the young children in the study were equally vulnerable to NTHi colonization. The researchers calculated that infants spending their days in day-care centers are more than two-and-a-half times more likely to have been colonized by NTHi than are children not in day care (30% vs. 11%, p < 0.001).

Though it is not the primary focus of their study, the researchers raise the question of “antimicrobial susceptibility,” an appropriate consideration given that heavy reliance on antibiotics by parents placing their children in day care has helped foster the emergence of pathogens resistant to such antibiotics. No wonder the researchers see in their findings serious “implications for both children and their caregivers.”

The advocates of maternal employment will continue to give assurances about the well-being of children in day care. But as the relevant research continues to accumulate, the number of listeners naïve enough to accept such assurances will surely dwindle.

(Sandra K. Shumacher et al., “Prevalence and Genetic Diversity of Nontypeable Haemophilus influenzae in the Respiratory Tract of Infants and Primary Caregivers,” Pediatric Infectious Disease Journal 31.2 [2012]: 145-149.)